Appeals Claims Specialist

Appeals Claims Specialist

Job ID

2017-2423

Category

Appeals and Denials

Location

US-UT-Draper

More information about this job

About The Company

MedData, a MEDNAX (NYSE: MD) company, is a technology-enabled services organization that improves financial outcomes for hospitals by enhancing the patient experience and expanding their access to healthcare. The MedData managed services program includes a range of patient access and communications, revenue cycle management, and consulting and analytics solutions for healthcare systems, including billing, coding, patient balances, eligibility and enrollment, third party liability, and mobile apps.

At MedData, we take great pride in our company, in each other, and in our 30+ year history of accomplishments and success. This pride is reflected in our everyday approach to working together. Each team member understands the importance of being part of a company that values their individual contributions and strives to help them achieve their personal goals as they work together to achieve the broader corporate goals. We believe that every team member contributes directly to MedData’s growth and success, and we are constantly searching for new talented, passionate and enthusiastic people who will take pride in being an integral part of our culture.

Job Description

MedData has an excellent career opportunity available as a Claims Specialist - Appeals to work in an office setting located in Draper, UT. The schedule for this full time role is Monday -Friday 8am-4pm.

POSITION OVERVIEW:

The purpose of this position is to review, submit and follow up on claims or medical bills for the Billing and Appeals Department. It is the primary responsibility of the Claims Specialist to ensure that claims are submitted timely, that they are processed accurately and, if required, denied services are appealed appropriately.

ESSENTIAL JOB FUNCTIONS:

Review and research insurance claims to determine possible payment source(s)

Contact various sources including insurance professionals, patients, and other parties to verify relevant data

Coordinate with payors to ensure appropriate filing guidelines are met for reimbursement

Assist in defending the hospital’s or medical provider’s rights to recovery against insurance companies

Interact with hospital staff members to obtain appropriate documentation for claims and appeals submission

QUALIFICATIONS:

High School Diploma or GED

Some college coursework preferred

1-2 years of related experience in the healthcare field or in a related area is preferred

Ability to communicate effectively verbally and in writing and be able to speak professionally with patients and insurance companies

Ability to proactively resolve issues

Creative problem solving skills

Ability to organize and set priorities according to situation all demands

Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications

This job description is to serve as a guide but no way is it to be considered a comprehensive list of task, duties and responsibilities that will be required by the employee.

To join our team of 2,000 employees and growing, please visit apply directly to this posting.